Characteristics and determinants of partial remission in children with type 1 diabetes using the insulin-dose-adjusted A1c definition

To evaluate the characteristics and determinants of partial remission (pr) in belgian children with type 1 diabetes (t1d),we analyzed records of 242 children from our center. clinical and biological features were collected at diagnosis and during follow-up. pr was defined using the insulin-dose-adjusted a1c definition. pr occurred in 56.2% of patients and lasted 9.2 months (0.5 to 56.6). 25.6% of patients entered t1d with dka,which correlated with lower pr incidence (17.6% versus 82.3% when no dka). in our population,lower a1c levels at diagnosis were associated with higher pr incidence and in young children (0-4 years) initial a1c levels negatively correlated with longer pr. early a1c levels were predictive of pr duration since 34% of patients had long prs (>1 year) when a1c levels were ≤6% after 3 months whereas incidence of long pr decreased with higher a1cs. c-peptide levels were higher in patients entering pr and remained higher until 3 years after diagnosis. initial antibody titers did not influence pr except for anti-ia2 titers that correlated with a1c levels after 2 years. presence of 2 versus 1 anti-islet antibodies correlated with shorter pr. pr duration did not influence occurrence of severe hypoglycemia or diabetes-related complications but was associated with lower a1c levels after 18 months. we show that,at diagnosis of t1d,parameters associated with β-cell mass reserve (a1c,c-peptide,and dka) correlate with the occurrence of pr,which affects post-pr a1c levels. further research is needed to determine the long-term significance of pr. © 2014 aurore pecheur et al.